Evergreen Prosthetics and Orthotics, LLC
NPI #1619096005 in Vancouver, Washington
Provider Information
- NPI Number
- 1619096005
- Entity Type
- Organization
- Organization Name
- Evergreen Prosthetics and Orthotics, LLC
- Primary Specialty
- Prosthetic/Orthotic Supplier
- Enumeration Date
- Mar 28, 2007
- Last Updated
- Nov 1, 2023
Practice Location
- Address
- 8614 E MILL PLAIN BLVD STE 110
- City
- Vancouver
- State
- Washington
- ZIP Code
- 98664-2058
- Phone
- (360) 213-2088
Authorized Official
- Name
- TIMOTHY L O'NEILL, CPO
- Title
- OWNER
- Phone
- (503) 704-5408
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
| Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment |
| Prosthetic/Orthotic Supplier |
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